Role of surgical excision in the treatment of large macrocystic lymphatic malformations in children
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Keywords
children, lymphatic malformations, surgical excision
Abstract
Background: Lymphatic malformations are rare benign congenital cystic lesions that can develop anywhere in the body. Therapeutic options for these lesions include intralesional sclerotherapy, surgical excision, and other modalities. Aim: This study aims to assess the safety and efficacy of complete surgical excision as a therapeutic option in the treatment of large macrocystic lymphatic malformations in children, as well as to introduce a novel modification to the surgical procedure. Methods: A prospective study was conducted on 14 patients with large macrocystic lymphatic malformations in different body locations, treated between October 2018 and October 2021 at our institution. Complete surgical excision using a continuous traction technique was the principle therapeutic approach, with no alternative modalities applied. Patients were followed up to assess postoperative cosmetic and functional outcomes, as well as recurrence. Results: Most enrolled patients, comprising 12 (85.7%), presented before the age of 2 years, with eight (57.1%) having lesions in the neck. Clinical diagnosis was possible in 11 (78.6%) cases. Complete surgical excision was successfully achieved in 12 (85.7%) patients, with no significant injury to vital structures. No postoperative functional problems were reported, and esthetic results were satisfactory in the vast majority (92.8%) of patients. Recurrence was not reported in any of the patients enrolled. Conclusion: Complete surgical excision proves to be a safe and effective initial therapeutic modality in the management of large macrocystic lymphatic malformations in children, yielding excellent postoperative results in terms of functional outcomes and recurrence. Utilizing a continuous traction technique during surgical excision has been instrumental in achieving these favorable outcomes.
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